My initial interest in ADHD began two years ago when my oldest daughter was diagnosed. It compelled me to dig into the research behind the nutritional recommendations for treatment. ADHD is characterized by inappropriate levels of inattention, impulsivity and hyperactivity in a child. In the United States, 9.5% of children from the ages of 4-17 years are diagnosed with ADHD and that number appears to be rising (chadd.org). Numerous treatment strategies exist, the most common is medication to help treat ADHD symptoms. Medications aren’t the answer for all children with ADHD, 20-35% of children don’t respond to them. Those who do respond well to medications may have negative effects, including loss of appetite, weight loss or/and sleep disturbances due to the stimulant medication. Also, medications for ADHD are not always covered by insurance or they may have a large co-pay. This can be a financial burden for parents, eliminating them as an option for some families.
Regardless of the choice to use medications or not, research on diet modification and the addition of Omega 3’s and micronutrient supplementation has shown to be beneficial to improve symptoms of hyperactivity, concentration and impulsivity. I have reviewed the vitamins and supplements here that are supported by research showing benefits and that I feel are worth considering to manage ADHD with your child nutritionally.
- Omega 3’s Fatty Acid:– Eicosapentaenoic acid (EPA) improves circulation in the brain Docosahexaenoic acid (DHA) is critical for nerve cell myelination and neural transmissions. Research suggests that children with ADHD have lower blood levels of omega-3’s than children without ADHD. Unless your child is a dedicated fish eater, you’ll have to supplement. Recommendations are to supplement with a higher ratio of EPA vs. DHA at 500-2000mg/day. You can read more about this nutrient and the research behind it in my blog post Omega 3’s For My ADHD Kid.
- Iron: Children with ADHD have been shown to have lower iron levels. There are some associations between serum ferritin levels and ADHD symptoms, so checking iron status can be very beneficial in order to supplement appropriately (ncbi.nlm.nih/gov).
- Zinc: A nutrient known to play a role in neuropsychiatric disorders, it contributes to the structure and function of the brain, forming neural pathways affecting neurotransmission. Low zinc status is linked to inattentiveness (Acta Med Croatica. 2009).
- Magnesium: Magnesium is involved as a cofactor in over 300 enzymatic reactions in the body. Magnesium is also used to make neurotransmitters involved in attention and concentration, and it has a calming effect on the brain. A deficiency of magnesium has been seen in children with ADHD and is tied to distractibility and hyperactivity. Magnesium can be toxic so it should only be given at moderate doses (<200mg/d). (Child Adoles Psych 2015)
- B6: Because pyridoxine has a positive effect on children with ADHD, it is recommended to supplement in order to regulate and normalize ADHD behaviors.
- Vitamin D: Essential for normal brain development. Most children are deficient in this sunshine” nutrient, especially in Oregon and Washington. Recommend supplementing 1000-2000 IU/day, more if shown to have a deficiency.
- Phosphatidyleserine: A naturally occurring phospholipid given at 200 mg/day has been studied to improve ADHD symptoms and short term memory in children. (Journal of Human Nutrition)
Other consideration (without as much research linked to ADHD): Probiotics, Folate, Choline, Carnitine, Antioxidants, Glutamine.
Since many micronutrients are involved with enzymatic reactions and play a large role in metabolism, neurotransmission, cognitive function, immune function, and detoxification, I highly recommend a comprehensive micronutrient panel in order to prevent over and/or under supplementation. I use Spectracell Micronutrient testing, which I find the most comprehensive and informative.
Children with ADHD can have food and/or chemical sensitivities and benefit from the elimination of their highly reactive foods and chemicals. The literature clearly demonstrates that some children with ADHD will benefit from an elimination diet and food sensitivities and allergies can be the trigger to the ADHD symptoms. In one recent study 50 children were placed on a restricted diet for five weeks, and 78 percent of them had significant improvements in ADHD symptoms (Child Adles Psych Feb 2015). Other studies have linked preservative sodium benzoate, food dyes and salicylates to hyperactive behavior (BMJ Journal). I use the Mediator Release Test (MRT) which tests 120 foods and 30 chemicals to identify reactive foods and chemicals and make recommendations of food eliminations based on the results of this test.
If your child is on medications with a low appetite, it’s crucial to focus on the meals your child will have the best appetite for, before meds or after the meds have worn off. Breakfast, dinner and bedtime snack should always be the largest and most nutrient dense to take advantage of your child’s appetite. Some parents choose to go off medications on the weekends and/or summer months to prevent the appetite suppressant effect. In some situations, an appetite stimulant will be beneficial.
Good nutrition can help all children with ADHD regardless if they are on meds, leading to increased focus and better behavior when the brain gets a steady supply of glucose and brain feeding nutrients. Include protein, fat and fiber at meals and snacks to help keep glucose to the brain steady throughout the day. Changing the diet to eat less processed foods, more whole foods in their natural state can make a big difference in order to cut down on artificial colors, preservative, and chemicals that have been linked to ADHD symptoms.
Diet for children with ADHD can be very complex. It’s always good to work with a dietitian who is experienced in ADHD to help provide guidance and support in this area of nutrition.